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{{Palmar plantar erythrodysesthesia}}
{{Palmar plantar erythrodysesthesia}}
{{CMG}}; {{AE}} {{MC}}


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==Overview==
A number of different [[Classification|classifications]] have been used for grading the severity of palmar plantar erythrodysesthesia (PPE). The [[Classification|classifications]] suggested by the [[National Cancer Institute|National Cancer Institute (NCI)]], and the [[World Health Organization|World Health Organization (WHO)]] are the two most commonly used.
 
==Classification==
 
* Palmar plantar erythrodysesthesia (PPE) may be [[Classif|classified]] into 3 grades according to the [[National Cancer Institute|National Cancer Institute (NCI)]].<ref name="urlProtocol Development | CTEP">{{cite web |url=https://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm |title=Protocol Development &#124; CTEP |format= |work= |accessdate=}}</ref>
 
{| class="wikitable"
|+Classification of PPE severity according to NCI Common Terminology Criteria for Adverse Events (CTCAE) v5.0
!GRADES
!
|-
!1
|
* Minimal [[skin changes]] (e.g, [[erythema]], [[edema]], or [[hyperkeratosis]]) without [[pain]]
|-
!2
|
* [[Skin changes]] (e.g, peeling, [[Blister|blisters]], [[bleeding]], [[Fissure|fissures]], [[edema]], or [[hyperkeratosis]]) with [[pain]]; limiting instrumental [[Activities of daily living|ADL]]
|-
!3
|
* Severe [[skin changes]] (e.g, peeling, [[Blister|blisters]], [[bleeding]], [[Fissure|fissures]], [[edema]], or [[hyperkeratosis]]) with [[pain]]; limiting self care [[Activities of daily living|ADL]]
|}<br />
 
*Palmar plantar erythrodysesthesis (PPE) may be [[Classification|classified]] into 4 grades based on the [[World Health Organization|World Health Organization (WHO)]]. <ref name="pmid11702367">{{cite journal| author=Nagore E, Insa A, Sanmartín O| title=Antineoplastic therapy-induced palmar plantar erythrodysesthesia ('hand-foot') syndrome. Incidence, recognition and management. | journal=Am J Clin Dermatol | year= 2000 | volume= 1 | issue= 4 | pages= 225-34 | pmid=11702367 | doi=10.2165/00128071-200001040-00004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11702367  }} </ref>
 
{| class="wikitable"
|+Classification of PPE severity according to WHO criteria
!GRADES
!
|-
!1
|
* [[Dysesthesia]]/[[paresthesia]], [[tingling]] in the [[Hand|hands]] and [[feet]]
|-
!2
|
* [[Discomfort]] in holding objects and upon walking, painless [[Edema|swelling]] or [[erythema]]
|-
!3
|
* [[Pain|Painful]] [[erythema]] and [[Edema|swelling]] of [[Palms of the hands|palms]] and [[Sole (foot)|soles]], periungual [[erythema]] and [[Edema|swelling]]
|-
!4
|
* [[Desquamation]], [[Ulcer|ulceration]], [[Blister|blistering]], severe [[pain]]
|}
 
==Gallery==
 
{|
|
[[Image:PPE grades.png|left|1000px|thumb| '''Palmar–plantar erythrodysesthesia''' <BR> Grades 1–3, according to the National Cancer Institute Common Terminology Criteria for Adverse events, version 4. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4576906/figure/MDV244F1/ Images shown above are courtesy of Siegfried Segaert and Eric Van Cutsem]]]
|}


==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Needs content]]
[[Category:Disease]]
[[Category:Disease]]
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<references />

Latest revision as of 18:58, 4 July 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mandana Chitsazan, M.D. [2]

Overview

A number of different classifications have been used for grading the severity of palmar plantar erythrodysesthesia (PPE). The classifications suggested by the National Cancer Institute (NCI), and the World Health Organization (WHO) are the two most commonly used.

Classification

Classification of PPE severity according to NCI Common Terminology Criteria for Adverse Events (CTCAE) v5.0
GRADES
1
2
3


Classification of PPE severity according to WHO criteria
GRADES
1
2
3
4

Gallery

Palmar–plantar erythrodysesthesia
Grades 1–3, according to the National Cancer Institute Common Terminology Criteria for Adverse events, version 4. Images shown above are courtesy of Siegfried Segaert and Eric Van Cutsem

References

  1. "Protocol Development | CTEP".
  2. Nagore E, Insa A, Sanmartín O (2000). "Antineoplastic therapy-induced palmar plantar erythrodysesthesia ('hand-foot') syndrome. Incidence, recognition and management". Am J Clin Dermatol. 1 (4): 225–34. doi:10.2165/00128071-200001040-00004. PMID 11702367.